infected toenail

Onychomycosis includes any type of infected toenail caused by dermatophyte fungi, non dermatophyre fungi or yeast. However, tinea ungium, refers strictly to dermatophyte infection of the nail plate. Onychomycosis is the most prevalent disease and accounts for almost fifty percent of all the diseases affecting the nails. Clinically, onychomycosis is divided into four types, distal subungual onychomysis, which occurs at distal end of nail plate, proximal subungual onychomycosis, white superficial onychomycosis and candidal onychomycosis.

toenail fungus

Onychomycosis is a common infection, with a prevalence of two to eight percent. However, few studies have shown an increase in prevalence. Causes of the disease include tight shoes, increasing numbers of immunosuppressed individuals, and an increased use of communal locker rooms. Dermatophytes are the major cause of onychomycosis, accounting for approximately seventy one percent of cases. Yeast infections are also a cause of toenail infections in almost five percent of the population and the majority of these are caused by candida albicans. The nondermatophytes account for approximately four percent of onychomycosis and they show predilection for previously diseased nails and older nails.

infected toenail treatment

Mostly, onychomycosis appears as a whitish to yellowish brown opacification at the distal edge of the nail. The infection then spreads throughout the nail. Hyperproliferation of the nail bed in response to the infection creates subungual hyperkeratosis and thus thickening of the nail. The nail markedly deteriorates as the progressive invasion of the nail plate occurs. Proximal subungual onychomycosis is evident as a white to beige opacity on the nail plate. This opacity gradually enlarges to affect the entire nail. White superficial onychomycosis is a direct invasion of the dorsal nail plate resulting in white to dull yellow patches anywhere on the surface of the toenail. Candida species invade via the hyponychial epithelium and affect the entire thickness of the nail plate.

Conditions leading to an infected toenail are psoriasis, eczema, lichen planus, onycgogryophosis, exfoliative dermatitis, Norwegian scabies and Reiter syndrome.

The diagnosis of an infected toe nail or onychomycosis rests on a potassium hydroxide examination of the nail, a nail biopsy and a fungal culture examination to detect the exact organism. Proper treatment is based mostly on the antifungal agents involved. Multiple systemic and topical antifungals are available and have proven quite effective against the dermatophytes. Treatment depends mostly on the severity of nail involvement and the causative agent. An infected toenail involving the nail matrix, the root, is treated with systemic antibiotics, while those not involving the matrix can be treated effectively with topical antibiotics.

Infected toenail